The technique was recently published 1 for helping the severe gagging patient who has endodontic treatment needs, thus requiring the use of rubber dams. Outside of dentistry, the Glossopharyngeal Nerve Block Technique has been used by anesthesiologists and otolaryngologists. This can be achieved using topical gels and sprays or doing nerve blocks to numb the tongue.
One of the most common ways to manage the gagging patient is with the use of topical or local anesthetics to numb either the tongue, roof of the mouth/soft palate area, or all of the above.Using my own personal experiences as well as anecdotes from fellow clinicians, I created a list of methods to help manage that gagging patient the next time they walk in your door. Therefore, the more tricks you have in your bag to manage these patients, the better off you and your patient will be. Until we know otherwise or have a “cure” for hypersensitive gag reflexes, we can only manage the issue using a variety of methods that may or may not work. Why do some people have worse gag reflexes than others? There is no clear evidence of what exactly causes the gag reflex to be worse on some patients than others, but it can be a mix of anatomical and/or constricted airways, hypersensitive gag reflexes, and directly or indirectly related anxiety/psychological issues.
So, what is the gag reflex and why do some people have it worse than others? The gag reflex, also known as the pharyngeal reflex, is a protective mechanism to help prevent something from occluding the throat/pharynx/larynx/trachea area and expelling it out of the way to help protect the airway. And, since almost everything we do is related to invading this area that sets off the gag reflex, you have to figure out ways to manage those patients and help them maintain their oral health in a way that works for everyone involved. They are the patient whose gag reflex goes crazy if you simply place a mirror in their mouth or if they lay back too far in the chair. If you have been in dentistry for any time at all, you know that one of the challenges we deal with when it comes to patient management is the gagging patient.
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